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chronic problems during 90 day global period

Amy Posted Wed 09th of October, 2019 02:19:11 AM
if the provider mention chronic problems in A/P during 90 day global period. can we consider these are unrelated problems and can apply 24 modifier to EM. please review.
SuperCoder Answered Fri 11th of October, 2019 05:19:03 AM

Hi Amy,

If the E&M service has been performed for the chronic problem during the post-op period and unrelated to the procedure for which patient is under global period, then it can be billed with modifier 24.

Append modifier 24 to an E/M service when the provider renders an E/M during the patient’s global surgery period, but the E/M is not related to the patient’s surgery.

When you report modifier 24, the E/M service must meet these criteria:

  • The E/M service occurs during the postoperative period of another procedure.
  • The current E/M service is unrelated to the previous procedure.
  • The same physician (or tax ID or same group and specialty) who performed the previous procedure provides the E/M.
  • The patient’s diagnosis documented must meet medically necessity for the visit.

Sometimes a physician examines a patient within the 90–day global period of a major procedure, but for a different problem. For instance, the physician operated on the patient's anus. A month later, he sees the patient for a stomach problem. That might be when you call on modifier 24 (Unrelated evaluation and management service by the same physician during a postoperative period).

When the patient has an E/M service with the provider for a postoperative visit, and the provider uncovers another unrelated problem during the visit, you can assign the no–charge code 99024 code for the postoperative visit, and an E/M code with modifier 24 for the unrelated problem.

 

Hope this helps!

Amy Posted Tue 15th of October, 2019 02:14:57 AM
thank you for guiding
SuperCoder Answered Wed 16th of October, 2019 00:44:24 AM

Thank you, happy to help.

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